The success of a healthcare facility depends on its revenue cycle management and in order to have a successful revenue cycle management it is necessary that a medical office specialist have knowledge of medical coding billing. This training manual will provide necessary knowledge for billing and coding. The knowledge of coding can be understood by having information about diagnostic coding and procedure coding. The knowledge of billing can be understood by having knowledge in various sections such as billing the patients for the services rendered, processing the claim and appealing a claim if it is denied. This training manual will provide an understanding of physician and hospital medical billing. It will also provide information about government…show more content… The purposes of ICD-9-CM coding are to evaluate medical necessity, give data for statistical analysis, and convert a long description of diseases into common language. There are three volumes of ICD-9-CM- Volume 1: ‘Tabular/Numerical list of diseases’ - is a list of diagnostic codes and descriptions of diseases and injuries. Volume 2: ‘Alphabetic index of disease’ – contains menu terms and modifiers, a table of drugs and chemicals, an index of external causes of injury and poisoning, and two special tables on hypertension and neoplasms. Volume 3: ‘Tabular and Alphabetic Index of Procedures’ – consists of two sections, a tabular list of codes and an alphabetic index. However, these codes are for procedures. There are some guidelines to follow when the coder is coding for diagnoses – (a) code the primary diagnosis first, followed by current coexisting conditions, (b) code to the highest level of certainty, (c) code to the highest level of specificity, (d) it is imperative to refer to all notes under the main term, (e) follow cross-reference instructions to assign a correct code, (f) always read notes such as ‘use additional code’, ‘excludes’, and ‘includes’ and follows instructions and (g) always follow fourth or fifth digit instructions. Some cases do require multiple or combination codes. For example, a case of poisoning is reported by using at least three…show more content… ICD-10 has three to seven alphanumeric characters. The ICD-10 replaces ICD-9 Volumes 1 and 2. The transition to ICD-10 will allow advanced coding accurateness and specificity, improved productivities and lower costs. Moreover, the transition will improve the capability to meet HIPAA electronic transaction and code set requirements. There are two important tools known as crosswalking and mapping that helps to achieve the transition of converting from ICD-9 to ICD-10. Crosswalks offer a direct match, a one-to-one relationship between ICD-9 to ICD-10. Mapping displays the complication of the code sets rather than simplifying. In addition, a reference mapping called General Equivalence Mappings (GEM) is used to direct the complication of translating between ICD-9 and ICD-10. However, there are some differences between ICD-9-CM and ICD-10-CM. For instance, ICD-9-CM lacks detail and laterality, whereas ICD-10-CM is very specific and has laterality. There are new features in ICD-10-CM such as codes for laterality; combination codes conditions and common associated symptoms and manifestations, combination codes for poisonings and much more. ICD-10-PCS has four attributes including completeness, expandability, multiaxial, and standardized terminology. This allows unique codes to be assigned to each new procedure as they develop and to each different
